MEMBERSHIP FORM FOR JNV SHINE HEALTH CARE SOCIETY....
Universal form for JNV SHINE GROUP....this form used for jnv shine health care society membership
Email address *
JNV SHINE
NAME *
Your answer
FATHER NAME *
Your answer
PRESENT ADDRESS *
Your answer
PERMANENT ADDRESS *
Your answer
Are you Navodayan, if yes please select yes, and other than Navodayan please give your higher degree details with institute name and pass out year *
JNV NAME & STATE
Your answer
CURRENT PROFESSION *
Your answer
JNV PASSOUT YEAR
Your answer
JNV PASSOUT
CONTACT NUMBER *
Your answer
SPECIAL SKILL
Your answer
ID PROOF (with id number) *
Your answer
DECLARATION *
Your Name
Your answer
MEMBERSHIP CATEGORY (Please visit www.jnvshine.org for membership contribution by using Pay Now Button,after membership approval) *
I agree to follow JNV SHINE HEALTH CARE SOCIETY rules and regulations and hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I undertake to inform you of any changes therein, immediately. In case any of the above information is found to be false or untrue or misleading or misrepresenting, I am aware that I may be held liable for it. I hereby authorize sharing of the information furnished on this form with the competent government authority. Membership completed after contribution of 10000 INR . *
A copy of your responses will be emailed to the address you provided.
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